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| 肺部超声评分在颅脑损伤患者术后肺部并发症的预测价值 |
| Predictive value of lung ultrasound score for postoperative pulmonary complications in patients with craniocerebral injury |
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| DOI：10.12089/jca.2025.01.009 |
| 中文关键词: 肺 超声 颅脑损伤 术后肺部并发症 Logistic模型 预测 |
| 英文关键词: Lung Ultrasonography Craniocerebral injury Postoperative pulmonary complications Logistic models Prognosis |
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| 中文摘要: |
目的：探讨术后早期肺部超声（LUS）评分在颅脑损伤患者术后肺部并发症（PPCs）中的预测价值。
方法：选择2020年1月至2024年4月因创伤性脑出血行急诊开颅手术的患者141例。记录术后第1天、第4天、第7天的LUS评分。记录患者术后10 d PPCs的发生情况，PPCs包括肺部感染、呼吸衰竭、胸腔积液、肺不张以及非计划二次气管插管。根据是否发生PPCs将患者分为两组：PPCs组和非PPCs组。采用多因素Logistic回归分析单因素差异有统计学意义的变量，确定术后发生PPCs的独立危险因素。采用受试者工作特征（ROC）曲线分析LUS评分对开颅手术患者发生PPCs的预测价值。
结果：本研究共纳入患者141例，有90例（63.8%）发生PPCs。与非PPCs组比较，PPCs组ICU住院时间及总住院时间明显延长（P＜0.05），术后第1天LUS评分明显升高（P＜0.05）。多因素Logistic回归分析结果显示，术后第1天LUS评分升高（OR=2.283，95％CI 1.421～3.668，P=0.021）是开颅手术患者术后发生PPCs的危险因素。术后第1天LUS评分最佳截断值为12.5分时，预测颅脑外伤手术患者发生PPCs的曲线下面积为0.894（95％CI 0.801～0.986），敏感性74.2％，特异性93.3％。
结论：术后第1天LUS评分升高是颅脑损伤患者术后10 d内发生PPCs的危险因素，且具有一定的预测价值。 |
| 英文摘要: |
Objective: To explore the predictive value of early postoperative lung ultrasound (LUS) score for postoperative pulmonary complications (PPCs) in patients with craniocerebral injury.
Methods: A total of 141 patients who underwent emergency craniotomy for traumatic intracerebral hemorrhage from January 2020 to April 2024 were selected. LUS scores were recorded on the 1st, 4th, and 7th days after surgery. The occurrence of PPCs within 10 days after surgery was also recorded, and PPCs include pulmonary infections, respiratory failure, pleural effusion, atelectasis, and unplanned secondary endotracheal intubation. The patients were divided into two groups based on the presence of PPCs: PPCs group and non-PPCs group. Multivariate logistic regression analysis was used to determine the independent risk factors for PPCs. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of LUS score for PPCs in craniotomy patients.
Results: There were 141 patients in this study. Ninety patients (63.8%) experienced PPCs. Compared with the non-PPCs group, ICU and total hospitalization days, and LUS scores on the first day after surgery were significantly increased in the PPCs group (P < 0.05). Multivariate logistic regression analysis showed that an elevated LUS level on the first postoperative day (OR = 2.283, 95% CI 1.421-3.668, P = 0.021) was a risk factor for the development of PPCs in craniotomy patients. When the optimal cutoff value of the LUS score on the first postoperative day was 12.5, the area under the curve for predicting PPCs in craniotomy patients was 0.894 (95% CI 0.801-0.986), with a sensitivity of 74.2% and a specificity of 93.3%.
Conclusion: An elevated LUS score on the first postoperative day is an independent risk factor for PPCs within 10 days after surgery, and that has certain predictive value. |
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